I recently had some lab testing to rule out polycystic ovary syndrome, a condition that produces a variety of symptoms, some of which overlap with bipolar symptoms. This brought up even more questions about the quality of care I had been receiving. I already knew it wasn’t great, but the fact that the first thing the new psychiatrist did was order more testing to rule out alternate causes of mood swings was a bit of an eye-opener.
When I first went in to a psychiatrist (several of them, actually) for diagnosis and treatment, no lab work was ordered despite my 20-year history of psychoactive medications. After a few months on Lamictal and getting stabilized on the new medication regimen, the PA I was seeing finally ordered a fairly comprehensive set of tests to verify that everything else was OK. It seems pretty obvious that the testing should have come before treatment, but at the same time, I was in bad shape then. I heartily agreed that it was more important to start treatment immediately, and that did end up being the right course of action. All of my tests have returned normal (or nearly normal) results.
But this does highlight the fact that there are a lot of other conditions that can cause similar symptoms to mood disorders. Just a few that come to mind include developmental disorders (like ADD), food or environmental allergies, deficiencies in various vitamins and minerals, hormonal imbalances, and thyroid problems. There are plenty more where those came from. Notably, not every condition is as easily mimicked as others; it seems depression is the most common mental health issue associated with a wide range of somatic illnesses. I haven’t come across any diseases that can cause symptoms that look remotely like mania, though there may well be something out there.
To most psychiatrists every complaint is a symptom of a mental illness, and medication is the foregone conclusion. That doesn’t mean they shouldn’t try to rule out other causes or conditions; they do have their MDs, after all, and I have seen mentions from many mental health bloggers about the importance of verifying that there aren’t other causes for symptoms leading to a diagnosis of a serious mental illness. But the fact of the matter is that it doesn’t always happen. Not all psychiatrists are created equal, and there are plenty for whom due diligence is whipping out the prescription pad and loading up the medicine cabinet.
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